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Abstracts / Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health 2 (2012) 240–339
from January 1, 1980 to December 31, 2006, and comparing them to 912 normotensive twin pregnancies. Results: No significant differences were observed between the two groups in relationship to birth weight, inter-twin weight discordance and growth restriction rate, with a trend towards a higher birth weight in GH group. In normotensive group, the discordance >25% was associated with a lower gestational age at the delivery (p < 0.00001). Moreover, the rate of pregnancies with SGA second twin gradually rose while paralleling the degree of discordance. Conclusion: Contrary to preeclampsia in twin pregnancies the outcome of those complicated by GH is similar to normotensive ones. The trend towards a higher birth weight in GH seems apparently paradoxical, but it may reflect the role of uncomplicated hypertension in twin pregnancies: the increased blood pressure could be a physiologic response for more blood nutrient supply to the fetuses. Disclosure of interest: None declared. doi:10.1016/j.preghy.2012.04.140
PP030. Cardiovascular disease and risk in a pregnant woman’s father as a risk factor for preeclampsia C.E. Parker 1,*, D.A. Doherty 1, B.N. Walters 2 (1 School of Women’s and Infants’ Health, The University of Western Australia, Nedlands, Australia, 2 Obstetric and Gynaecology CCU, King Edward Memorial Hospital for Women, Subiaco, Australia) Introduction: In women experiencing their first pregnancy the assessment of risk of developing a hypertensive disorder of pregnancy (HDP) including preeclampsia is imprecise. Identification of women at higher than normal risk of developing preeclampsia may improve pregnancy management and lead to better outcomes. Previous studies, mostly retrospective, have indicated a possible link between cardiovascular history and risk of preeclampsia. Objectives: To evaluate the self-reported family history of cardiovascular disease and risk (CVD/R) during an antenatal interview as a means of screening for risk of developing preeclampsia or other HDP. Methods: Nulliparous women were recruited prospectively in early pregnancy before diagnosis of any HDP. Women reported on their maternal characteristics and the history of cardiovascular health in themselves, their parents and siblings and the father of the baby and his parents and siblings. Cardiovascular health was assessed as cardiovascular risk (high blood pressure, high cholesterol and diabetes) and cardiovascular disease (heart attack, stroke, angina and any major vascular surgery). Pregnancy outcomes were recorded after delivery, the diagnoses of gestational hypertension, preeclampsia and superimposed preeclampsia being assigned according to the criteria defined by SOMANZ, 2008. A nominal logistic regression analysis was used to evaluate the effects of family history on risk of developing HDP while adjusting for clinical risk factors known at the time of recruitment. Results: Nine hundred and ninety-seven women completed the study. Median gestational age at recruitment was
31.3 weeks (Interquartile range [IQR] 24.4–35.9, range 5.6– 39.1). Median age was 27.0 years (IQR 23.0–32.0, range 16.0– 45.0), median BMI was 28.6 (IQR 24.8–36.4, range 16.7–64.4) and 76.4% of the women did not smoke during the pregnancy. Preeclampsia was diagnosed in 12.6% of the women (103/ 997 preeclampsia, 23/997 superimposed) and 6.2% developed gestational hypertension (62/997). CVD/R was reported by 22.3% of mothers (including 1.7% of CVD alone) and in 9.3% of the partners (including 1.7% of CVD alone). Women reported CVD/R in 39.1% of their mothers (including 6.5% CVD alone) and in 42.2% (including 13.3% CVD alone) of their fathers. Women reported CVD/R in 30.3% (including 6.1% CVD alone) of the partners’ mothers and in 38.9% (including 15.0% CVD alone) of the partners’ fathers. Women who knew of CVD/R in their fathers had increased risk of preeclampsia (16.2% vs. 10.1%; Odds Ratio [OR] = .66 95% Confidence Interval [CI] 1.16–2.36, p = .005) that remained elevated after adjustments for maternal age, BMI, smoking in pregnancy and maternal CVD/R. No similar increase in risk of gestational hypertension was evident (7.4% vs. 5.4%; OR = 1.31 95% CI 0.81–2.10, p = 0.272). CVD/R reported for any other family member did not significantly alter the woman’s risk of developing preeclampsia or any other HDP. Conclusion: The presence of a history of CVD/R in the father of the pregnant woman indicated an increased risk of developing preeclampsia. The possibility of a similar association between CVD/R in other family members and HDP may exist however women in their first pregnancy may not have sufficient knowledge of family history. This lack of comprehensive information may limit the potential value of family history in determining the risk of preeclampsia and other hypertensive disorders in pregnancy. Disclosure of interest: None declared. doi:10.1016/j.preghy.2012.04.141
PP031. The prevalence of microalbuminuria following preeclampsia J. Spaan 1,*, L. Peeters 2, M. Spaanderman 1 (1 Obstetrics and Gynecology, Maastricht University Medical Center, Maastricht, The Netherlands, 2 Obstetrics and Gynecology, University Medical Center Utrecht, Utrecht, The Netherlands) Introduction: About 7 years after preeclampsia, the prevalence of microalbuminuria is reported to be around 30% [1]. As proteinuria resolves in most cases within two years of post partum, [2] this raises the question of whether microalbuminuria first regresses after preeclampsia or persists. Objectives: This cross-sectional study describes the prevalence of microalbuminuria in the years following preeclampsia. Methods: Women with a history of preeclampsia (n = 823) were evaluated 4–180 months after delivery. Women with pre-existing hypertension, renal disease or diabetes mellitus were excluded (n = 65). In a 24 h urine collection we deter-
Abstracts / Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health 2 (2012) 240–339
from January 1, 1980 to December 31, 2006, and comparing them to 912 normotensive twin pregnancies. Results: No significant differences were observed between the two groups in relationship to birth weight, inter-twin weight discordance and growth restriction rate, with a trend towards a higher birth weight in GH group. In normotensive group, the discordance >25% was associated with a lower gestational age at the delivery (p < 0.00001). Moreover, the rate of pregnancies with SGA second twin gradually rose while paralleling the degree of discordance. Conclusion: Contrary to preeclampsia in twin pregnancies the outcome of those complicated by GH is similar to normotensive ones. The trend towards a higher birth weight in GH seems apparently paradoxical, but it may reflect the role of uncomplicated hypertension in twin pregnancies: the increased blood pressure could be a physiologic response for more blood nutrient supply to the fetuses. Disclosure of interest: None declared. doi:10.1016/j.preghy.2012.04.140
PP030. Cardiovascular disease and risk in a pregnant woman’s father as a risk factor for preeclampsia C.E. Parker 1,*, D.A. Doherty 1, B.N. Walters 2 (1 School of Women’s and Infants’ Health, The University of Western Australia, Nedlands, Australia, 2 Obstetric and Gynaecology CCU, King Edward Memorial Hospital for Women, Subiaco, Australia) Introduction: In women experiencing their first pregnancy the assessment of risk of developing a hypertensive disorder of pregnancy (HDP) including preeclampsia is imprecise. Identification of women at higher than normal risk of developing preeclampsia may improve pregnancy management and lead to better outcomes. Previous studies, mostly retrospective, have indicated a possible link between cardiovascular history and risk of preeclampsia. Objectives: To evaluate the self-reported family history of cardiovascular disease and risk (CVD/R) during an antenatal interview as a means of screening for risk of developing preeclampsia or other HDP. Methods: Nulliparous women were recruited prospectively in early pregnancy before diagnosis of any HDP. Women reported on their maternal characteristics and the history of cardiovascular health in themselves, their parents and siblings and the father of the baby and his parents and siblings. Cardiovascular health was assessed as cardiovascular risk (high blood pressure, high cholesterol and diabetes) and cardiovascular disease (heart attack, stroke, angina and any major vascular surgery). Pregnancy outcomes were recorded after delivery, the diagnoses of gestational hypertension, preeclampsia and superimposed preeclampsia being assigned according to the criteria defined by SOMANZ, 2008. A nominal logistic regression analysis was used to evaluate the effects of family history on risk of developing HDP while adjusting for clinical risk factors known at the time of recruitment. Results: Nine hundred and ninety-seven women completed the study. Median gestational age at recruitment was
31.3 weeks (Interquartile range [IQR] 24.4–35.9, range 5.6– 39.1). Median age was 27.0 years (IQR 23.0–32.0, range 16.0– 45.0), median BMI was 28.6 (IQR 24.8–36.4, range 16.7–64.4) and 76.4% of the women did not smoke during the pregnancy. Preeclampsia was diagnosed in 12.6% of the women (103/ 997 preeclampsia, 23/997 superimposed) and 6.2% developed gestational hypertension (62/997). CVD/R was reported by 22.3% of mothers (including 1.7% of CVD alone) and in 9.3% of the partners (including 1.7% of CVD alone). Women reported CVD/R in 39.1% of their mothers (including 6.5% CVD alone) and in 42.2% (including 13.3% CVD alone) of their fathers. Women reported CVD/R in 30.3% (including 6.1% CVD alone) of the partners’ mothers and in 38.9% (including 15.0% CVD alone) of the partners’ fathers. Women who knew of CVD/R in their fathers had increased risk of preeclampsia (16.2% vs. 10.1%; Odds Ratio [OR] = .66 95% Confidence Interval [CI] 1.16–2.36, p = .005) that remained elevated after adjustments for maternal age, BMI, smoking in pregnancy and maternal CVD/R. No similar increase in risk of gestational hypertension was evident (7.4% vs. 5.4%; OR = 1.31 95% CI 0.81–2.10, p = 0.272). CVD/R reported for any other family member did not significantly alter the woman’s risk of developing preeclampsia or any other HDP. Conclusion: The presence of a history of CVD/R in the father of the pregnant woman indicated an increased risk of developing preeclampsia. The possibility of a similar association between CVD/R in other family members and HDP may exist however women in their first pregnancy may not have sufficient knowledge of family history. This lack of comprehensive information may limit the potential value of family history in determining the risk of preeclampsia and other hypertensive disorders in pregnancy. Disclosure of interest: None declared. doi:10.1016/j.preghy.2012.04.141
PP031. The prevalence of microalbuminuria following preeclampsia J. Spaan 1,*, L. Peeters 2, M. Spaanderman 1 (1 Obstetrics and Gynecology, Maastricht University Medical Center, Maastricht, The Netherlands, 2 Obstetrics and Gynecology, University Medical Center Utrecht, Utrecht, The Netherlands) Introduction: About 7 years after preeclampsia, the prevalence of microalbuminuria is reported to be around 30% [1]. As proteinuria resolves in most cases within two years of post partum, [2] this raises the question of whether microalbuminuria first regresses after preeclampsia or persists. Objectives: This cross-sectional study describes the prevalence of microalbuminuria in the years following preeclampsia. Methods: Women with a history of preeclampsia (n = 823) were evaluated 4–180 months after delivery. Women with pre-existing hypertension, renal disease or diabetes mellitus were excluded (n = 65). In a 24 h urine collection we deter-
